tbuckley/cabot-search huggingface dataset:
Abstract P649: Juvenile Exercise Delays Frailty and Promotes Metabolic Health in Aged Mice
Authors: Mengya Feng, Min Li, Nini Zhang, Jing Lou, Guiling Wu, Fangqin Wu, Yanzhen Tan, Hongyan Yang, Wenli Yan, Xuyun Liu, Jia Li, Jiankang Liu, Xing Zhang, Feng Gao
Journal: Circulation (2023)

Introduction: Physical exercise is well-recognized for its beneficial effects on health. Acute or short-term effects of exercise have been extensively studied; however, it remains unclear whether exercise in juvenile has sustained beneficial effects until old age. Hypothesis: We hypothesized that juvenile exercise would delay frailty and promote metabolic health in aged mice. Methods: Male and female mice were divided into sedentary and exercise groups, and each group contains 50 mice. Mice in exercise group started swimming at 1 month of age and stopped at 4 month of age (1.5 hour per day and 5 days per week). No exercise intervention was conducted in other time. The general health, cardiac function, metabolism and other parameters were examined in aged mice. Transcriptional profiling of various tissues and organs was performed to obtain insight into mechanisms that how juvenile exercise affects aged mice. Results: Juvenile exercise mice showed significant reduction in frailty and improvement in metabolic health compared with sedentary controls. Both male and female juvenile exercise mice were scored lower in frailty at the age of 24 months. Juvenile exercise improved the integument and physical/musculoskeletal status of male mice. For females, juvenile exercise reduced frailty in all aspects. Female juvenile exercise mice weighted more than sedentary mice at 24 months old but male groups showed no difference. The cardiac function, food consumption, grip strength and rotarod running time between two groups also presented no difference at 24 months. Juvenile exercise mice showed improved flexibility in substrate usage at the age of 24 months under fasting condition. Aged mice in exercise group showed significant higher energy expenditure, fat and carbohydrate oxidation than their controls. KEGG overrepresentation analysis for the differentially expressed genes demonstrated that pathways altered by juvenile exercise were most related to metabolism, especially lipid metabolism. Conclusions: These results demonstrate that regular and moderate physical exercise in juvenile age extends health span in mice, highlighting the sustained beneficial effects of juvenile exercise.
Abstract MP07: Changes in Weight From Sugar- or Artificially-Sweetened Beverages or Water Intake in a Prospective Cohort
Authors: Alan Espinosa-Marrón, Yi Wan, Josiemer Mattei, Frank B Hu, Walter C Willett
Journal: Circulation (2023)

Background: It is still unclear if sustained intake of artificially sweetened beverages (ASB) in lieu of sugar-sweetened beverages (SSB) is associated with long-term weight reduction or maintenance. This study aimed to evaluate the long-term changes in weight and BMI in relation to changes in ASB intake, and to estimate the effects of replacing SSB with ASB or water on body weight. Hypothesis: Habitual ASB intake is unrelated to weight or BMI changes. The modeled substitutions are expected to show a reduction in weight and BMI, larger for water than for ASB. Methods: We used data from the Nurses' Health Study I, a prospective cohort study conducted among female US nurses aged 39 to 65y at enrolment and assessed every four years from 1986 to 2010. Food-frequency questionnaires evaluated usual dietary intake including beverages (in 12 oz servings/day). Self-administered questionnaires collected lifestyle and anthropometric information. We excluded participants with any major disease at baseline (e.g., diabetes, cancer, cardiovascular disease), and censored those reaching 65 years during follow-up. Pregnant or lactating women were not considered during these periods. We evaluated the association between changes in ASB intake with changes in weight and BMI using generalized estimating models adjusting for multiple dietary and lifestyle risk factors. Substitution models assessed how replacing SSB with ASB, SSB with water, or ASB with water relates to weight and BMI changes, adjusting for the same covariates. Results: Among 51,805 participants, 64.6% consumed ASB at baseline averaging 0.25 ± 0.53 servings/day. Over 4-year follow-up intervals, a one-serving/day increase of ASB was associated with an estimated weight change of -0.06 kg (95% CI: -0.11, -0.02) and BMI change of -0.02 kg/m 2 (95% CI: -0.04, -0.01). Substituting SSB with ASB was associated with -0.37 kg change in weight (95% CI: -0.41, -0.33) and -0.14 kg/m 2 in BMI (95% CI: -0.17, -0.11). Similar estimates were observed when replacing SSB with water ( β =-0.35 kg, 95% CI: -0.41, -0.30 for weight and β =-0.13, kg/m 2 , 95% CI: -0.15, -0.11 for BMI). Substituting ASB with water was not associated with changes in weight ( β =-0.004 kg, 95% CI: -0.05, 0.04) or BMI ( β =-0.0002 kg/m 2 , 95% CI: -0.02, 0.02). Conclusion: A long-term daily increase in ASB intake was not associated with greater weight gain in US women. Replacing SSB with ASB was associated with significantly less weight gain, likely by reducing energy intake. Change in water was not associated with weight changes, suggesting it may help sustain weight maintenance when replacing SSB. Future studies should evaluate the roles of changes in intakes of water, ASB, and SSB in relation to changes in other weight- and metabolically-related outcomes in diverse populations of both sexes.
Abstract P625: Differences in Urban/Rural Oral Anticoagulation and Mortality Among People With Incident Venous Thromboembolism: Medicare 20% Sample 2016-2018
Authors: Rob F Walker, Neil A Zakai, Richard F Maclehose, Faye L Norby, Wendy Wang, Alvaro Alonso, Pamela L Lutsey
Journal: Circulation (2023)

Introduction: Oral anticoagulants (OAC) are a standard and highly efficacious treatment for venous thromboembolism (VTE), with newer direct oral anticoagulants (DOACs; rivaroxaban and apixaban) equivalent or preferred over warfarin for many patients. Rural residents often lack easy access to medical care, which may cause differences in OAC use and outcomes in people with incident VTE. Hypothesis: People enrolled in Medicare who reside in rural locations will be less likely to be prescribed DOACs for primary treatment of incident VTE and will experience higher 6-month mortality compared to patients residing in urban areas. Methods: We used the Medicare 20% sample to identify a cohort of individuals aged ≥65 years with incident VTE and prescribed an OAC from 2016-2018. Risk factors, demographics, and ZIP codes to create urban/rural categories based on rural-urban commuting area codes were defined at time of VTE diagnosis. All-cause mortality and death date were ascertained via Medicare linkage to the Social Security Administration. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association of urban/rural status and 6-month mortality rates, adjusting for demographics, comorbidities and medications. Urban/rural status and OAC choice were tested for multiplicative interaction. Results: Among 37,954 beneficiaries with VTE (mean age 76.7, SD 8.1), 82% were urban and 18% were rural. There were 3,778 deaths within 6 months of VTE diagnosis; 3,130 among urban residents while 649 among rural residents (83% vs. 17%). Overall, warfarin was prescribed more often in rural areas than urban areas (34% vs. 27%), rivaroxaban prescriptions were less common in rural versus urban areas (32% vs. 36%), and apixaban did not differ by rural versus urban status (35% vs. 37%). In multivariable-adjusted analyses, risk of mortality was not significantly different in rural versus urban areas (HR: 1.08 (0.99-1.17)). The HRs for mortality with rivaroxaban versus warfarin was 0.85 (95% CI: 0.79, 0.93), for apixaban versus warfarin it was 0.96 (95% CI: 0.89, 1.04), while for apixaban versus rivaroxaban it was 1.14 (95% CI: 1.05, 1.23). There was no interaction between OAC prescribed and urban/rural status for all comparisons of OACs (p-interaction rivaroxaban vs. warfarin: 0.50; apixaban vs. warfarin: 0.54; apixaban vs. rivaroxaban: 0.27). Conclusions: Rural versus urban residence resulted in less prescription of DOACs versus warfarin or oral anticoagulation treatment of VTE, but not a significant difference in 6-month mortality. The reasons for different prescribing patterns are unclear, whether due to comorbid conditions or provider knowledge. Greater attention to understanding rural-urban treatment differences is needed to ensure high quality care for everyone.
Abstract P647: Assessing the Current Practice of Home Blood Pressure Reporting During Pregnancy
Authors: Hannah Wisniewski, Sravya Shankara, Ekaterina Skaritanov, Mawulorm Denu, Stephen P Juraschek, Lara Kovell
Journal: Circulation (2023)

Background: Hypertension (HTN) during pregnancy is a leading cause of fetal and maternal morbidity and is increasingly prevalent in the United States. Home blood pressure (HBP) monitoring allows for blood pressure surveillance throughout pregnancy and can prompt pregnant women to seek medical attention if their blood pressure exceeds safe thresholds. Objectives: To assess the current practice of HBP reporting in pregnancy. Methods: We enrolled 38 pregnant women at 24-32 weeks gestation with either a chronic HTN diagnosis or systolic blood pressure of 140-159 and 40 pregnant women without HTN between July 2019 and November 2021. Clinic visits (telehealth and in-person) were retrospectively reviewed. Each visit with recordings of HBP was categorized as: exact HBP readings, ranges of readings, or qualitative assessment (e.g., normal) of HBP readings during pregnancy and postpartum. Two-sample test of proportion was used for comparisons. Results: Of the 38 women with HTN, 27 (71%) had at least one recorded HBP in pregnancy or postpartum, compared to 2 (5%) women without HTN. There was a total of 158 prenatal visits with HBP recorded and 39 readings postpartum. Readings were more likely to be reported as an exact HBP in the postpartum period (49%) vs. prenatal period (23%, p = 0.001, Figure ). In the prenatal period, 47% of the visits recording HBP reported a range of readings. Discussion: In this population of pregnant women with HTN, we observed substantial heterogeneity of HBP monitoring and reporting during pregnancy and postpartum. Exact HBP reporting in the postpartum period may be related to fewer postpartum follow-up visits. With an increased focus on remote patient monitoring, digital health tools may be important for standardization of HBP monitoring in clinician reporting. Figure: Number of reports by type prenatal and postpartum. Each mention of HBP monitoring in the medical record was coded as an exact reading reported, a range of readings reported, or a qualitative report (“HBP has been within normal limits”)
Abstract P406: Association Between Perceived Interpersonal Racism and Incident Coronary Heart Disease Among Black Women
Authors: Shanshan Sheehy, Max Brock, Julie R Palmer, Michelle A Albert, Yvette Cozier, Lynn Rosenberg
Journal: Circulation (2023)

Background: Racism is highly prevalent in our society and has disproportionate impact on Black individuals. However, little data exists about whether perceived interpersonal racism are associated with risk of coronary heart disease (CHD). Methods: We followed 48,297 participants in the Black Women’s Health Study from 1997, when they provided information on perceived interpersonal racism and were free of cardiovascular disease and cancer, until the end of 2019. We averaged participant’s responses to the five questions about perceived interpersonal racism in everyday activities, such as “people act as if they think you are dishonest.” We summed up the positive responses to the three questions for perceived racism in interactions that involved jobs, housing, and police; score ranged from 0 (No to all) to 3 (Yes to all). We used Cox proportional hazard models to assess the relation of perceived interpersonal racism with incident CHD, adjusting for major confounders. Results: During 22 years of follow-up, we identified 1,036 incident CHD cases. Women who were in the highest quartile of perceived interpersonal racism in daily life had a 21% increased risk of incident CHD (multivariable hazard ratios (HR)=1.21, 95% confidence interval (CI): 0.99-1.48, p trend=0.05), compared to women in the lowest quartile. Women who reported experience of racism in employment, housing, and the criminal justice system had a 29% increased risk (multivariable adjusted HR=1.29, 95%CI: 1.03-1.63, p trend=0.05) of CHD relative to those who reported no such perceived racism. Conclusion: Perceived experiences of racism in the context of employment, housing and the criminal justice system were associated with increased incidence of CHD among Black women. These findings support the hypothesis that experiences of racism may explain some of the disproportionately high incidence of CHD in the Black population.
Abstract P620: Microbiota Composition and Diversity Are Associated With Fat Tissue Quality: Findings From Baltimore Longitudinal Study of Aging
Authors: Curtis Tilves, Toshiko Tanaka, Moira K Differding, Adam Spira, Chee Chia, Luigi Ferrucci, Noel T Mueller
Journal: Circulation (2023)

Background: Human studies have reported associations of the gut microbiome with central adiposity, including with pathologic visceral adipose tissue (AT) area. However, AT quality (e.g., lipid content, fibrosis) can vary at similar AT areas. Lower AT x-ray radiodensity reflects lower AT quality and has been associated with greater cardiometabolic risk. To our knowledge, no studies have examined associations of gut microbiome features with AT radiodensity. Objective: To test the hypothesis that gut microbiota diversity and composition are associated with abdominal AT area and radiodensity. Methods: The Baltimore Longitudinal Study of Aging is a cohort of community-dwelling older adults. From 2013 to 2017, we collected fecal samples for shotgun metagenomic sequencing; a subset of participants (N=428) also had abdominal computed tomography scans. We measured area and radiodensity of both subcutaneous (SAT) and visceral (VAT) AT. We examined associations of microbiota alpha and beta diversities with fat measures using linear regression and PERMANOVA, respectively. We tested for bacterial species associations using ANCOM-BC. We adjusted statistical models for age, sex, race, education, and physical activity. Results: Our study sample had a mean age of 73.6 years and BMI of 27.6 kg/m 2 , was 52.8% female, and 26.9% identified as Black. A 1-SD increment in the alpha diversity Shannon Index metric was associated with -600.8 mm 2 lower VAT area (95%CI: -1106.0, -95.5), but was not associated with other fat measures. VAT area and VAT or SAT radiodensity were associated with weighted UniFrac. Multiple bacterial species associated with larger VAT area were also associated with lower VAT or SAT radiodensity, including species previously associated with central adiposity (e.g., Ruminococcus gnavus ). Conclusion: In this large cohort of older US adults, bacterial species associated with larger VAT area were also associated with a measure of worse AT quality, suggesting these bacterial species may drive adipocyte dysfunction.
Abstract P525: Associations of Body Mass Index Variability From Childhood and Midlife Dyslipidemia
Authors: Soo Jung Kang, Ileana De Anda-Duran, Shirine Moukaled, Camilo Fernandez, Lydia A Bazzano
Journal: Circulation (2023)

Background: In adults, short periods of weight loss followed by weight gain, known as body mass index(BMI) variability, has been linked to adverse cardiovascular outcomes. However, the impact of long-term BMI variability from childhood on midlife dyslipidemia is unclear. We identified this effect in a cohort of Black and White midlife adults living in a rural community. Methods: We studied 1,268 midlife participants of the Bogalusa Heart Study (age at baseline 9.5 ± 3.5 years, age at midlife 48.2 ± 5.2 years, 59.5% women, 34.4% black) with ≥4 measurements of BMI and other traditional cardiovascular risk factors (CVRF) from childhood. Long-term BMI variability was computed as deviation from age-predicted values (DEV). The associations between long-term BMI variability and dyslipidemia and dyslipidemia subtypes were assessed by logistic regression, adjusting for age, sex, race, CVRF, depression, alcohol use, education, and employment status. Interactions between race, sex and long-term BMI variability were assessed. Results: Prevalence of midlife dyslipidemia were 88.01%(n=1116). DEV was positively significantly associated with having midlife dyslipidemia. Stratified analyses showed that men had higher odds of having midlife dyslipidemia, HDL-C&lt;60 mg/dL, and triglycerides ≥150 mg/dL with 1 unit increase in DEV, compared to those of women. White participants had higher odds of having triglycerides ≥150 mg/dL with 1 unit increase in DEV compared to Black participants. (see Table 1) Conclusions: We identified associations between long-term BMI variability from childhood and midlife dyslipidemia. Race and sex were found to modify the associations of long-term BMI variability on having midlife dyslipidemia and dyslipidemia subtypes. Further studies are needed to determine the role of long-term BMI variability as a predictor for increased risk of midlife dyslipidemia.
Abstract MP14: Association Between Housing Insecurity With Reduced Access to Healthcare and Cardiovascular Disease Prevention: The Behavior Risk Factor Surveillance System (BRFSS) Study
Authors: Bisma Khwaja, Jamie Ng, Lauren J Sinks, Diana Aguilar-Cruz, Frances M Wang
Journal: Circulation (2023)

Introduction: Risk factors including hypertension and hyperlipidemia increase the risk of cardiovascular disease (CVD). Yet, the significantly increased prevalence of CVD in housing insecure populations cannot be explained by the diagnosed prevalence of these risk factors alone. These populations may face unique barriers to care related to lack of access to screening, prevention, and treatment that complicate heart health. Hypothesis: Access to quality healthcare and CVD prevention is reduced for the housing insecure population, independent of income and sociodemographic factors, compared to housing secure populations. Methods: Using data from the 2017 Behavior Risk Factor Surveillance System (BRFSS), housing insecurity was self-reported as not being able to pay mortgage, rent, or utility bills over the past 12 months. Weighted multivariable logistic regressions were used to calculate adjusted odds ratios for the healthcare access variables. Results: In our study population, 8.79% (51.8% female, 71.7% white) experienced housing insecurity. Compared to housing secure individuals, housing insecure individuals were more likely to not have a primary care doctor (OR 1.25 [1.16-1.35]), be unable to afford doctor visits (3.89 [3.63-4.16]), report pending medical bills (2.62 [2.33-2.93]), have Medicare (1.26 [1.01-1.57]) or Medicaid (1.83 [1.46-2.28]), experience gaps in healthcare coverage (2.94 [2.45-3.53]), delayed medical care (2.38 [2.10-2.70]), and were 4 times more likely to not take medications as prescribed due to cost (4.39 [3.86-4.99]). Among those with known hypertension and hypercholesterolemia, respectively, people experiencing housing insecurity were more likely to not be taking antihypertensive (1.35 [1.20-1.51]) and cholesterol-lowering medications (1.33 [1.18-1.48]). Conclusion: Housing insecure populations experience significant healthcare access disparities, potentially exacerbating health outcomes through the underdiagnosis, prevention, and treatment of CVD.
Abstract P509: Does HDL-C Classification as a Criterion for Metabolic Syndrome Contribute to Alleviated Risks of Future Atherosclerosis and Incident Diabetes Among Midlife Women? The Study of Women’s Health Across the Nation (SWAN)
Authors: Ziyuan Wang, Monique Hedderson, Carol A Derby, Maria M Brooks, Rebecca C Thurston, Sybil L Crawford, Imke Janssen, Daniel McConnell, Emma Barinas-Mitchell, Samar R El Khoudary
Journal: Circulation (2023)

Introduction: In women, metabolic syndrome (MetS) is identified when at least 3 of the following risk factors exist: waist circumference &gt; 88 cm, HDL-C &lt; 50 mg/dL, triglycerides (TG) ≥ 150 mg/dL, fasting glucose ≥ 110 mg/dL, and hypertension. However, previous studies challenged the belief that HDL-C is protective for midlife women, casting doubts on HDL-C as one of the criteria for diagnosing MetS in this population. Hypothesis: We hypothesize that among midlife women classified as having MetS based on criteria independent of HDL-C, HDL-C classification does not contribute to risk of future subclinical atherosclerosis or incident diabetes. Methods: Participants from the SWAN study with complete data on MetS were classified into the following groups: 1) no MetS or 2) MetS independent of HDL-C; which was classified into MetS with HDL-C ≥ 50 mg/dL (MetS high), or MetS with HDL-C &lt; 50 mg/dL (MetS low). Carotid intima-media thickness (cIMT) was measured after 13.8±0.6 years of follow-up. Incident diabetes was recorded based on medication use, fasting glucose ≥ 126 mg/dL and/or self-reports over time. Linear regression and discrete-time survival analysis were used for analysis. Results: Among 2994 women age 45.9±2.7 years, 2528 had no MetS (88%), 85 had MetS high (3%), and 235 had MetS low (8%) at baseline. In model 1, compared to no MetS group, MetS high or low group had higher cIMT and higher odds of diabetes. The risk did not differ between MetS low vs. high group. Adjusting for levels of MetS criteria other than HDL-C explained the associations of each of the two MetS groups with cIMT. Conversely, MetS with low HDL-C remained associated with a higher risk of incident diabetes ( Table 1 ). Conclusions: Midlife women with MetS have elevated risk for incident diabetes and subclinical atherosclerosis regardless of HDL-C levels. The elevated risk is explained by levels of criteria of MetS other than HDL-C for cIMT but not for diabetes. Low HDL-C on top of other MetS criteria doesn’t contribute equally to future cardiovascular risk prediction in midlife women.